Frequently Asked Questions

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No. Medicare isn’t part of the Health Insurance Marketplace, so if you have Medicare coverage now you don’t need to do anything. If you have Medicare, you’re considered covered.  Click Here to read more on www.healthcare.gov website

If you’re retired and need health coverage, you can use the Marketplace to buy an insurance plan. If you don’t have coverage you may have to pay a fee.

If you have retiree health coverage, you have different choices to consider.

Have Medicare? Learn about Medicare and the Marketplace.

If you retire before age 65 without health coverage
If you retire before you’re 65 and lose your job-based health plan when you do, you can use the Health Insurance Marketplace to buy a plan.

Losing health coverage qualifies you for a Special Enrollment Period. This means you can enroll in a health plan even if it’s outside the annual Open Enrollment Period.

If you want to enroll because you lost your job-based coverage, see our Special Enrollment Period page for more information.

When you fill out a Marketplace application, you’ll find out if you qualify for a private plan with premium tax credits and lower out-of-pocket costs. This will depend on your income and household size.

You’ll also find out if you qualify for free or low-cost coverage through the Medicaid program in your state.

If you have retiree health benefits
If you have retiree health benefits, you’re considered covered under the health care law. You don’t have to pay the penalty that people without insurance must pay.

If you have retiree coverage and want to buy a Marketplace plan instead, you can. But:

You can’t get premium tax credits and other savings based on your income. This is true only if you’re actually enrolled in retiree coverage. If you’re eligible for but not enrolled in retiree coverage, you may qualify for premium tax credits and lower out-of-pocket costs based on your household size and income.

If you voluntarily drop your retiree coverage, you won’t qualify for a Special Enrollment Period to enroll in a new Marketplace plan. You won’t be able to enroll in health coverage through the Marketplace until the next Open Enrollment period.